What You Need to Know About Immunotherapy

The New Cancer Treatment Breakthrough (3:41)

The word breakthrough gets thrown around in the media when it comes to medical advances. In the actual science and medical world, it’s significantly less used. But in 2016 the American Society of Clinical Oncology reported that immunotherapy—a new technique for treating cancer—might make the strongest case in some time for the title.

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“I believe it’s the next level of oncology care,” says Bibas Reddy, DO, a medical oncologist with Plaza Medical Center of Fort Worth in Texas. “It’s a big deal because in oncology we used to apply the term breakthrough for some drugs getting approved based on increased survival of days or weeks. Now with some newer forms of therapies patients can have survival increases measured in months and years.”

Cancer is a complex disease process. It “manipulates your immune system into leaving it alone,” says Dr. Reddy. Enter immunotherapy. “What immunotherapy is attempting to accomplish is taking the brakes off that process,” he says.

There are various types of immunotherapy used for cancer treatment. Some identify cancer cells, making it easier for your immune system to locate and destroy them. Others strengthen your immune system, making it easier for your body to work against the cancer. Researchers are learning more about how “targets" on tumor cells evolve as a tumor grows, and they’re beginning to use this to create immunotherapy treatments to attack each person’s cancer in novel ways that are more individualized instead of a one-size-fits-all approach.

According to Reddy, the first type of cancer that researchers found to respond well to immunotherapy was melanoma. President Jimmy Carter was treated for stage 4 melanoma in 2015; as his treatment showed, immunotherapy can be used for late-stage cancer that otherwise might be a death sentence. “Even in metastatic melanoma, you have the potential to elicit a response where older treatments had little or no response,” says Reddy. “I think it’s something now that every patient facing metastatic melanoma needs to be considered for.”

One method that garnered headlines in 2016 involving T-cells (white blood cells that attack the bad stuff in the body, like bacteria and viruses) was staggeringly successful. In a small study (yet to be published as of February 2016) that began in 2013, some 94 percent of the acute lymphoblastic leukemia patients and more than just over half of the patients with other blood cancers went into remission. This type of immunotherapy, however, is not without its drawbacks. Complications may include fever, low blood pressure, and damage to the nervous system—and for some, it may prove fatal.

Despite the potential for serious side effects, most immunotherapy treatments are tolerated much better than traditional chemotherapy or radiation. Chemotherapy and radiation not only kill cancer cells but also can harm healthy cells, leading to side effects such as loss of appetite, increased bleeding and bruising, severe nausea, vomiting, diarrhea, and hair loss. “The side-effect profile tends to be a little more favorable with immunotherapy, but there are some unique ones,” says Reddy. Rashes are common, and some treatments can cause pneumonitis, an inflammation of the lungs.

Reddy says immunotherapy is making headway in the treatment of kidney cancers, lymphomas, and head and neck cancers. “Kidney cancer is the next big cancer type to see what works and what doesn’t versus more traditional targeted therapies,” Reddy says. Immunotherapy has been shown to be effective in certain lung cancers as well.

Immunotherapy and other innovative cancer treatments like targeted therapies represent a new and promising avenue for research, and they have even experienced oncologists like Reddy excited. “We used to talk about the future and what was possible, but the future is here now, and it’s an exciting time to be on the front lines of cancer care. This is a definite change in the paradigm of how we have approached cancer treatment in the past,” says Reddy.